🏛️ OpenDoor Healthcare - Physician Independence Platform

Market-Making Layer for Practice Acquisition & Embedding

The platform that makes all physicians—whether solo, group, health-system-employed, or fresh grads—independent through data-driven practice valuation and Independence OS embedding

1. THE MARKET OPPORTUNITY - WHY OPENDOOR EXISTS
THE MARKET DYSFUNCTION TODAY SELLER (Retiring or burnt-out physician) Problem: 18 months to sell Broker fees + uncertainty BUYER (Young doc or PE firm) Problem: Can't value practice No transparency, no leverage BROKEN MIDDLE Brokers • Lawyers • Chaos Result: Practices close. Physicians retire early. Practices are undervalued. Buyers can't find good targets. Healthcare consolidates to mega-health-systems. Physician independence dies. OPENDOOR BECOMES THE MARKET MAKER ONE PLATFORM • FOUR PHYSICIAN ARCHETYPES • ONE GOAL: INDEPENDENCE We become the BUYER for selling physicians We become the LENDER for buying physicians We become the AGGREGATOR for PE firms We become the LIBERATOR for health-system docs wanting out Clear pricing algorithm (based on 3-yr taxes, payer mix, ZIP code, tenure) 30-day close (we hold equity, handle transition) Embed Independence OS tools → practice becomes profitable immediately Physician stays or exits, we own the practice + the data network
OpenDoor's Core Thesis: The practice acquisition market is broken because there's information asymmetry and no standardized pricing. Real estate has Zillow/Redfin. Healthcare has nothing. We become that market maker by: (1) Publishing a transparent valuation algorithm for ALL practices in the US, (2) Acquiring from sellers at fair market prices with 30-day closes, (3) Embedding Independence OS immediately so practices become cash-flowing assets, (4) Selling or leasing to buyers (physicians, groups, PE firms) who want established patient bases. Our dog in the fight: we embed our tools and scale them across the network. The more practices we own/control, the more data we collect, the better our algorithms get.
2. FOUR PHYSICIAN ARCHETYPES & OPENDOOR'S ROLE
🏥 TYPE 1: SOLO/SMALL PRACTICE OWNER
Current situation: Owns practice, wants to exit or monetize
Today's pain: 18-month broker process, hidden fees, uncertainty
What they need: Fast, fair exit at market value
OpenDoor's play: Buyer of last resort. 30-day acquisition.
Mechanics:
→ Provide 3yr tax returns + payer mix data
→ Algorithm generates price in 1 week
→ LOI signed, close in 30 days
→ They can retire OR stay as employee
👥 TYPE 2: GROUP PRACTICE MEMBER
Current situation: Part of group, wants independence or exit
Today's pain: No value extracted for leaving the group
What they need: Buyout + transition mechanism
OpenDoor's play: Intermediary between leaving doc and group
Mechanics:
→ Pay group for departing physician's patient panel
→ Retain physician as employee or partner
→ Embed Independence OS for flexibility
→ Physician captures own economics
🏛️ TYPE 3: HEALTH SYSTEM EMPLOYED
Current situation: Employed by health system, RVU-based comp
Today's pain: No autonomy, RVU burnout, misaligned incentives
What they need: Independence WITHOUT financial risk
OpenDoor's play: Spin-out operator + Independent OS layer
Mechanics:
→ Acquire clinic from health system
→ Physician becomes partner (not employee)
→ Maintain referral relationships w/ system
→ Flexibility + profit share + no RVU pressure
🎓 TYPE 4: FRESH GRADUATE
Current situation: Student debt, wants to own practice
Today's pain: Can't get financing. No equity path.
What they need: Capital + mentorship + established patient base
OpenDoor's play: Venture lender + practice provider
Mechanics:
→ Underwrite physician debt from day 1
→ Place in established practice (test-drive)
→ If successful after 2yr: acquire practice as partner
→ If not: work as employee, debt covered
The Genius of Four Archetypes: Type 1 & 2 are your acquisition funnel—practices flow IN to OpenDoor. Type 3 is your expansion engine—you can spin out units from health systems. Type 4 is your buyer pipeline—fresh docs need practices + capital. You're not just a buyer or a seller; you're the entire market infrastructure. Every transaction embeds your tools. Every practice becomes a data node in your network.
3. PRACTICE VALUATION & ACQUISITION WORKFLOW
PHASE 1: DISCOVERY Physician outreach: 1M+ US physicians Search by specialty ZIP code targeting Age/tenure profiles Agentic outreach: AI-personalized emails "Your practice may be worth $X. Interested?" Discovery data: ☐ Interested in exit? ☐ Practice type? ☐ Current challenges? ☐ Willing to stay 1yr? OUTPUT: ✓ Cohort of interested physicians ✓ Practice type classification ✓ Preliminary exit parameters ✓ Contact + consent for next phase PHASE 2: UNDERWRITING Data collection: 1. Tax returns (3 yrs) 2. Patient panel size 3. Payer mix breakdown 4. EMR extract (deidentified) Algorithm calculates: • Revenue per patient • Profitability trends • Care gaps (untapped $) • RCM inefficiency • Geographic multiplier Valuation formula: Base = avg revenue/pt × patient panel count × payer mix multiplier × ZIP code factor = Acquisition price OUTPUT: ✓ Definite offer price ✓ Pricing breakdown ✓ Transition requirements ✓ LOI ready for signature PHASE 3: TRANSACTION (30 DAYS) Day 1-3: Physician signs LOI Engage lawyer Share purchase agreement Day 4-15: • Credential review • License verification • DEA/NPI transfer • Insurance assignment • IT readiness Day 16-30: • Final audit • Wire funds • Sign closing docs • Transition begins OUTPUT: ✓ Shares transferred ✓ Physician paid ✓ OpenDoor owns practice ✓ Day 1 transition plan PHASE 4: EMBEDDING (Independence OS) Day 1-7: Scribe agents go live RCM automation starts Staff training Week 2-4: • Quality gap detection • Patient engagement • Denial automation • Metrics dashboards Month 2: Full stack operational Economics visible: ↑ Patients/day +15% ↑ Claims acceptance 95% ↑ Quality gaps -30% OUTPUT: ✓ Practice operating at 110%+ efficiency ✓ Physician happy (less admin) ✓ Revenue + outcomes improved ✓ Ready for sale or hold
The 30-Day Acquisition Machine: Traditional practice sales take 18 months because of information asymmetry and trust issues. OpenDoor compresses this to 30 days through: (1) Transparent algorithmic pricing (no haggling), (2) Standardized documentation (3-yr taxes, payer mix, patient panel), (3) Automated underwriting, (4) Fast legal close (LLC/MDPA shares), (5) Immediate embedding of Independence OS. The key insight: we don't just close the deal, we prove ROI within 30 days. Physician sees their revenue up 15%, claims accepted on first try, and admin burden down 2 hours/day. That success story becomes your best marketing.
4. MARKET INTELLIGENCE & ONTOLOGY - "THE PRACTICE KNOWLEDGE GRAPH"
DATA INPUTS Tax Returns Revenue patterns CMS Data Patient volume Payer Data Mix + reimbursement EMR Extracts Clinical patterns Demographic Physician age, tenure Geographic ZIP codes, markets Acquired Data Transition outcomes PRACTICE KNOWLEDGE GRAPH - NORMALIZED ONTOLOGY Physician → Practice → Patient Panel → Revenue Streams → Payer Rules → Clinical Patterns → Geographic Factors Relationships: Specialty→Peer Group, Practice→Market Comparables, Physician→Transition Risk, Panel→Care Gaps VALUATION ENGINE Calculate fair market value for any US practice Inputs: taxes, payer mix, ZIP, tenure Outputs: purchase price + ROI projection MARKET SEGMENTATION Identify physician segments most likely to exit Age 55+, declining revenue, debt Care gaps (optimization opportunity) ROI PROJECTION ENGINE Show physician what practice could earn with Independence OS Gap closing +$50k/yr, RCM +$30k/yr Patient retention +15% = $100k+ upside OPENDOOR PLATFORM OUTPUTS PRICING TRANSPARENCY Public valuation algorithm Practice worth calculator (Zillow-style) Neighborhood market comps ROI projections with/without OpenDoor BUYER-SELLER MARKETPLACE Match retiring docs with young buyers Match PE firms with growth regions Financing available for buyers Historical deal data + success rates TRANSITION INTELLIGENCE Practice change readiness score Staff retention risk assessment Patient loyalty prediction Embedding success probability SPECIALTY INSIGHTS Cardiology practices sell for $400/pt Peds practices trending +10% YoY Gap closure upside varies by specialty Most attractive regions for buyers
The Practice Knowledge Graph: This is your Palantir Foundry equivalent. Every practice acquisition adds a node. Every transition outcome trains your models. Every physician profile becomes intelligence. You publish the valuation algorithm (transparency creates trust). You build buyer-seller matching. You predict transition success. Over time, you have 1000s of data points on "what makes a practice acquisition successful?" That becomes your competitive moat—not just the deals, but the knowledge that makes future deals faster and more profitable.
5. HOW EACH PHYSICIAN ARCHETYPE FLOWS THROUGH OPENDOOR
TYPE 1: SOLO OWNER (SELLER PATH) Trigger: Age 55+, declining revenue, burnout, retirement thoughts OpenDoor outreach: "Your practice is worth $X." "We can close in 30 days." Decision tree: ✓ Want to exit? → Sell ✓ Want to stay? → Transition ✓ Part-time? → Stay as employee ✓ Uncertain? → Advisory role OUTCOME OPTIONS: A) Full exit: physician paid, retires B) Transition: stay 1yr, earn bonus C) Hybrid: part-time + equity stake D) Advisory: consulting relationship All options: embedding happens Day 1 Practice becomes profitable asset OpenDoor holds equity + data network TYPE 2: GROUP MEMBER (INDEPENDENCE) Trigger: Wants autonomy, RVU burnout, misaligned with group strategy OpenDoor play: Pay group for departure Physician becomes partner Mechanics: 1. Negotiate buyout $ w/ group 2. Carve-out patient panel 3. Physician keeps patient base 4. Independence OS launched OUTCOME: ✓ Physician is now independent ✓ Captures own profit margin ✓ No RVU pressure ✓ Flexible hours (embedded tools) OpenDoor: owns practice + tools layer Can add more docs to clinic or sell Data aggregates to specialty cloud TYPE 3: HEALTH SYSTEM (SPINOUT) Trigger: System wants to shed lower-margin clinics OpenDoor play: Acquire clinic from system Physician spins out as partner Key difference: Physician still does referrals But now independent operator Profit sharing + no RVU model Independence OS = flexibility OUTCOME: ✓ System divests underperformers ✓ Physician becomes owner (happy) ✓ Referral volume maintained ✓ Practice becomes profitable OpenDoor: manages spinout process System can scale this playbook Opens 50+ spinout opportunities TYPE 4: FRESH GRAD (DEBT + PLACEMENT) Trigger: $200k debt, wants practice ownership, no access to capital OpenDoor play: Underwrite physician debt Place in established practice 2-Year test drive: 1. Young doc = employee for 2yr 2. Learns practice, builds patient base 3. If successful: acquire practice as partner (we finance) OUTCOME A (SUCCESS): ✓ Physician owns practice ✓ Debt manageable with Independence OS OUTCOME B (DOESN'T FIT): ✓ Stays as employee (debt covered) ✓ Low risk, predictable income
All Four Paths Lead to Embedding: Whether it's a solo practitioner exiting, a group member seeking independence, a health-system doc wanting autonomy, or a fresh grad seeking ownership—every path ends with Independence OS embedded. You're solving their unique pain (exit liquidity, autonomy, spinout mechanics, financing) while achieving your goal (tools embedded, data collected, practice profitable). The genius: you're not forcing one model. You're offering options and letting physicians choose. That creates loyalty and network effects.
6. HYDERABAD TEAM STRUCTURE - DELTA + FORWARD DEPLOYED MODEL

Team B (Hyderabad) - 10 Engineers + 1 CEO

Mandate: Build the OpenDoor platform that makes practice acquisition + embedding seamless, transparent, and repeatable across four physician archetypes.

Platform & Core Teams (Bangalore-based)

Market Intelligence & Valuation (3)
Lead: Data scientist + product owner
Owns: Practice knowledge graph, valuation algorithm, market segmentation, ROI projections
Deliverable: Public pricing tool (Zillow for practices)
Acquisition Workflow Engine (2)
Lead: Product engineer
Owns: Data collection, LOI generation, document management, close coordination
Deliverable: 30-day acquisition automation
Agentic Outreach & CRM (2)
Lead: AI product engineer
Owns: Physician discovery, AI-personalized emails, interest qualification, interest tracking
Deliverable: Automated pipeline generation
Embedding Orchestration (2)
Lead: Platform engineer (connects to Independence OS team)
Owns: Independence OS deployment coordination, practice transition timeline, success metrics
Deliverable: Day-1 embedding for acquired practices
Operations & Analytics (1)
Lead: Data engineer
Owns: Deal tracking, success metrics, physician outcomes, platform observability
Deliverable: Real-time deal dashboard

Forward-Deployed & Field Teams (On-site w/ customers)

Forward-Deployed Engineers (2-3 FTE equivalent)
Location: Embedded with first 5-10 practices
Role: "Delta engineers" in Palantir terminology
Responsibilities:
→ Understand physician pain in real-time
→ Debug Integration issues live
→ Gather transition feedback
→ Report back to Bangalore on platform gaps
→ Iterate on embedding process
Acquisition Operations Manager (1)
Location: Split between Hyderabad & field
Manages: Deal pipeline, physician communication, document coordination, legal workflows
What Forward-Deployed Feeds Back
Weekly: "Which practices are struggling?" → product fixes
Weekly: "What docs ask most?" → outreach messaging
Bi-weekly: "What docs like about process?" → refinements
Monthly: "Are Independence OS tools sticking?" → embedding process improvements
Why This Structure Works: Bangalore team builds the platform (scalable, algorithmic, reusable). Forward-deployed team lives in the field (understands physician reality, catches problems early, iterates. They talk every day. Bangalore ships features based on FD feedback. FD tests them immediately. Within 3-6 months, you have a machine that: (1) Reaches 1M+ physicians, (2) Qualifies deal pipeline, (3) Acquires 20+ practices/month, (4) Embeds tools with 95%+ success rate, (5) Gets better every practice.
7. EXECUTION ROADMAP - BUILD THE MARKET MAKER

Phase 1 (Months 1-3): BOOTSTRAP WITH YOUR CURRENT PRACTICES

Sprint 1: Valuation Algorithm (Internal)
Goal: Reverse-engineer OpenDoor-style pricing from your own acquisitions. Show that transparent algorithm works.
Build: Market Intelligence team creates formula (taxes × patient count × payer mix × ZIP × specialty).
Measure: Algorithm predicts your actual acquisitions with 90%+ accuracy.
Sprint 2: Embedding Playbook
Goal: Document exact steps to embed Independence OS in a new practice (Day 1-30).
Build: Embedding Orchestration team creates runbook.
Measure: Can you replicate your best acquisition 3 times identically?
Sprint 3: Agentic Outreach Prototype
Goal: Test AI-generated emails to target physicians in your current ZIP codes.
Build: Agentic team builds email generator + interest tracker.
Measure: 500 emails → 50 interested physicians (10% conversion).

Phase 2 (Months 4-6): SCALE TO 50+ PRACTICES

Sprint 4: Public Valuation Tool Launch
Goal: Beta launch pricing calculator on OpenDoor website.
Build: Web UI for "What's my practice worth?"
Measure: 1000+ physicians use tool in first month. Average query: 2-3 minutes.
Sprint 5: Acquisition Automation
Goal: 30-day close from LOI to money transfer.
Build: Workflow engine automates doc collection, LOI generation, legal handoff.
Measure: Close 10 practices with avg. 28-day timeline.
Sprint 6: Physician Matching Marketplace
Goal: Connect buyers (fresh grads, PE firms) with sellers (retiring docs).
Build: Simple marketplace: "Practices for sale" + "Financing available"
Measure: 5-10 transactions facilitated through platform.

Phase 3 (Months 7-12): VERTICAL SPECIALIZATION

Build Specialty Clouds (Parallel)
Cardiology cloud: 20+ cardiology practices. Algorithm tuned for cardiology valuation. Payer rules embedded. Referral patterns learned.
Pediatrics cloud: 15+ peds practices. Same pattern.
Measure: Each specialty cloud = $2-5M annualized revenue.
Expand Outreach to 5 States
Goal: Move from ZIP-code targeting to regional market-making.
Build: Forward-deployed engineers embed in 3-4 regions.
Measure: 50+ inquiries/month from each region. 10+ closures/month.

Year 2 Vision: NATIONAL MARKET MAKER

Scale to 500+ Practices in Network
Goal: Become the de facto marketplace for practice acquisition in US.
Outcome: Every physician knows: "When I want to sell, I go to OpenDoor." Every buyer knows: "I find practices on OpenDoor."
Revenue: $20-50M ARR from practice ownership + transaction fees.
10 Specialty Clouds Operating
Cardiology, Pediatrics, Primary Care, Orthopedics, GI, Mental Health, etc.
Each cloud is a self-reinforcing learning machine with Independence OS embedded in every practice.
Data aggregation: 100,000+ patient panels generating signals on best practices, outcomes, quality.
For Hyderabad Team: Your Mission
You're not building a practice management software. You're building the operating system for practice transactions in healthcare.

OpenDoor is how we achieve our ultimate goal: Make every physician independent. Not by forcing one model, but by offering four paths and letting them choose. Solo doc wants to exit? We pay fair value and close in 30 days. Group member wants autonomy? We're the intermediary. Health system doc burned out? We're the spinout partner. Fresh grad needs capital? We finance them.

Our dog in the fight: Every practice acquisition embeds Independence OS. Every embedding creates data. Every data point trains our models. In 18 months, we've acquired 500+ practices. We own the market intelligence. No other company knows practice valuation like we do. No other company has embedded tools in this many practices. We've become essential infrastructure.

Your team builds this in three layers:
1. Market Intelligence (Bangalore): The algorithm, the transparency, the platform that makes physicians trust us
2. Acquisition Automation (Bangalore): The 30-day machine. Make it repeatable, testable, debuggable
3. Forward-Deployed (Field): You live with doctors. You see pain real-time. You feed back to Bangalore every day. Bangalore ships. You test.

Success metrics:
• Valuation algorithm predicts actual acquisition prices with 95%+ accuracy
• 30-day close from LOI to money transfer
• 50+ practices acquired in first 6 months
• 80%+ embedding success rate (tools stick, physicians happy)
• Agentic outreach generates 100+ qualified leads/month by month 6
• Independence OS embedded in 500+ practices by end of Year 1

The ripple effect: Each practice you help becomes a node in the specialty cloud. Each specialty cloud becomes a data asset. Each data asset makes the next acquisition easier, faster, cheaper. By Year 2, you're the market maker. By Year 3, you control the data network that healthcare operates on.

This is not a feature sprint. This is building the infrastructure that makes physician independence possible at scale.